Determinants of arterial stiffness progression in a Han-Chinese population in Taiwan: a 4-year longitudinal follow-up

Background: Arterial stiffness predicts the future risk of macro-and micro-vascular diseases. Only a few studies have reported longitudinal changes. The present study aimed to investigate the progression rate of arterial stiffness and the factors influencing stiffness progression in a Han Chinese population residing in Taiwan. Methods: The pulse wave velocity (PWV), elasticity modulus (Ep) and arterial stiffness index (beta) of the common carotid artery were measured in 577 stroke-and myocardial infarction-free subjects at baseline and after an average interval of 4.2 +/- 0.8 years. Stepwise multivariate linear regression was conducted to elucidate the predictors of stiffness progression. Results: For both baseline and follow-up data, men had significantly higher values of PWV, Ep and beta in comparison to women. The progression rates of PWV, Ep and beta were faster in men, but the difference was not statistically significant (Delta PWV = 0.20 +/- 0.20 and 0.18 +/- 0.20 m/s/yr; Delta Ep = 8.17 +/- 8.65 and 6.98 +/- 8.26 kPa/yr; Delta beta = 0.70 +/- 0.64 and 0.67 +/- 0.56 for men and women, respectively). In the multivariate regression analyses, age, baseline stiffness parameters, baseline mean arterial pressure (MAP), baseline body mass index (BMI) and changes in MAP (Delta MAP) were independent predictors of PWV and Ep progression. There was an inverse correlation between the stiffness parameters at baseline and their progression rate (correlation coefficient (r) = -0.12 to -0.33, p = 0.032-1.6 x 10(-16)). Changes in MAP (Delta MAP) rather than baseline MAP were more strongly associated with PWV progression (p = 8.5 x 10(-24) and 1.9 x 10(-5) for Delta MAP and baseline MAP, respectively). Sex-specific analyses disclosed that baseline BMI and changes in BMI (Delta BMI) were significantly associated with stiffness progression in men (p = 0.010-0.026), but not in women. Conclusions: Aging and elevated blood pressure at baseline and during follow-up were the major determinants of stiffness progression in the Han Chinese population. For men, increased baseline BMI and changes in BMI were additional risk factors.